Effectiveness of CBT Versus Standard Treatment for Childhood Anxiety Disorders in a Community Clinic Setting

Abstract

The efficacy of cognitive—behavioural therapy (CBT) for the treatment of childhood anxiety has mainly been demonstrated in university-clinic settings. This study aimed to evaluate the effectiveness of CBT for the treatment of childhood anxiety in a community mental health service, compared with standard treatments (‘Treatment as Usual’ [TAU]) 'child psychotherapy, family therapy and eclectic treatments. Fifty-four children with anxiety disorders, aged from 7 to 14 years, were randomly assigned to either a CBT or TAU group. CBT and the standard treatments were provided by 18 experienced therapists, and the mean number of treatment sessions was 12. Baseline and follow-up measures at 3, 6 and 12 months included an interview based on criteria in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) that was conducted by a clinical psychologist who was blind to the treatment conditions, and standardised anxiety measures (parent, child and teacher reports). Significant improvements were found on all anxiety measures over time, but no significant differences were found between CBT and TAU. The challenge of conducting such research in community settings is discussed.

Developing a model of mental health self-care support for children and young people through an integrated evaluation of available types of provision involving systematic review, meta-analysis and case study

“…51,107,133 There were no studies on psychosis. Most (31/71) of the studies concerned interventions that could be classified as treatments (see Chapter 1, Intervention levels), [48][49][50][51][52]55,65,66,70,71,74,77,78,81,[83][84][85][86]91,[94][95][96][97][98][101][102][103][104]106,111,112,[121][122][123][124][125][126][127][129][130][131]133,135,139 with the remainder focusing equally on indicated (n = 11), 53,58,59,…”

“…Sixteen of the interventions were individual child/young person or individual family interventions; 48,65,[69][70][71]74,[83][84][85][86][87][95][96][97][98]111,[121][122][123][124][125][126][127][129][130][131]133,135 the remainder were group interventions or group interventions with occasional individual sessions. Of those studies where a delivery location was given, most of the interventions (33/71) took place in a school setting, 39,[45][46][47]49,50,53,[57][58][59][60]62,63,65,73,82,[90][91][92][93][94]…”

“…running summer camps and liaising with teachers (MTA 1999 95 ), or facilitating the child in the home-school environment (Pfiffner 2007 102 ). In three-quarters (53/71) of the studies, the agents were trained specifically for the intervention, 39,[45][46][47][48][49][50][51][53][54][55][56][57][58][59][62][63][64][65][66][67][68][72][73][74][77][78][79][82][83][84][85][86][87][88][89][90]93,94,99,100,[103][104][105][106][108][109]…”

“…Eighteen (half) of the studies were also included in the effectiveness review. 39,48,51,[69][70][71]73,74,[83][84][85]87,90,91,93,101,102,110,113,118,119,136 The 36 studies are summarised in Appendix 9.…”

“…The location was unclear in the remaining studies. Psychologists were in the majority as the self-care support agent but they accounted for less than half (14/33) of the interventions; 48,69,73,83,84,91,101,102,118,119,[163][164][165]168,171,174 a range of specific (e.g. teachers and counsellors 39,90,93,110,113,136,170 ) and non-specific (e.g.…”